The Real Medicare Divide – The Treaters Vs. Rationers – That’s why I’m convinced the major fault line in the health care debate in the coming decades won’t be between those who do and don’t want to diminish the government’s role–by, say, replacing the open-ended benefits Medicare recipients now get with a Ryan-style limited subsidy for purchase of health insurance. Sure that’s one debate, and it’s happening now. But the bigger fault line will be the line that is just emerging, between those who want Americans to keep getting whatever health care will make them better–which is more or less Medicare’s current, costly posture–and those who accept some system, whether public or private, that would deny them some treatments because of their expense: The Treaters vs. the Rationers.**

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Read it all

Is Obama going to endorse the debt commission’s plan? – Obama will not blaze a fresh path when he delivers a much-anticipated speech Wednesday afternoon at George Washington University. Instead, he is expected to offer support for the [debt] commission’s work and a related effort underway in the Senate to develop a strategy for curbing borrowing. Obama will frame the approach as a responsible alternative to the 2012 plan unveiled last week by House Republicans, according to people briefed by the White House.

Letting others take the lead on complex problems has become a hallmark of the Obama presidency. On health care, last year’s tax deal and the recent battle over 2011 spending cuts, Obama has repeatedly waited as others set the parameters of the debate, swooping in late to cut a deal. The tactic has produced significant victories but exposed Obama to criticism that he has shown a lack of leadership.

The Post reporters also note that Obama will speak favorably of the so-called Gang of Six, a group of senators who favor a combination of tax hikes and spending cuts.

But what does this really mean? Saying nice things about a panel whose specific proposals he never endorsed and which are an anathema to much of his party doesn’t seem like a formula to move the ball ahead. A senior Republican Senate aide deems the “let others lead” approach as “ridiculous,” given the necessity of presidential leadership if we are to make progress on the debt.

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Well, Obama has to do something and class warfare is the easiest – despite the details.

Obama has not led on the economy, unemployment or foreign policy. What makes anyone think he will do anything different on the federal budget deficit?

Paul Ryan’s desperate critics on the LEFT – The Democrats have a problem. They can’t abide by the notion that we have to spend less on entitlement programs in order to solve our long- term debt, so rather than offer their own plan they’ve resorted to name-calling and straw-man arguments.

Ezra Klein, for example, deems Rep. Paul Ryan’s plan a “joke,” accusing him of failing to raise taxes (well, yes that’s true) and of savaging “programs serving the poor.” Actually, Ryan would impose means-testing of the rich on Medicare and give block grants to the states to try to more effectively manage health services delivered to the poor. If we do nothing, of course, these plans will collapse. A Ryan spokesman had this to say:

The CBO warns that if policymakers don’t take action to save Medicare, taxes “would reach higher levels relative to the size of the economy than ever recorded in the nation’s history, payments to physicians under Medicare would be reduced well below current rates, and payments to other Medicare providers would grow more slowly than the cost of their inputs; nevertheless, federal debt would continue to grow relative to GDP.”

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Read it all.

So, what does Ezra Klein want to do when Medicaid, Social Security and Medicare collapse under their own weight?

Another government bailout? And, that works how when the country is bankrupt?

Paul, who said yesterday that he would vote against the agreement reached last Friday to cut $39.9 billion between now and September, acknowledged that he's considering waging a filibuster, which would make it so that leaders need 60 votes to pass the deal and advance it to President Obama's desk.

"Yes, but we haven't really made a final decision on that yet," Paul said on conservative talker Sean Hannity's radio show.

A filibuster would make it difficult for the Senate to pass the budget deal by midnight Friday, when the government's spending measure expires.

Paul acknowledged that even if he were to filibuster, it's unlikely that he'll attract 40 other senators' votes in order to sustain his procedural roadblock to the budget deal.

But such a move might crystallize conservative dissatisfaction with the deal brokered by House Speaker John Boehner (R-Ohio) in last-minute negotiations with Obama and Senate Majority Leader Harry Reid (D-Nev.). Conservatives are angry the deal falls short of the benchmark of $100 billion in cuts below Obama's original budget proposal for this fiscal year.

Paul said that he would be more inclined to block action in the upper chamber if it led to consideration of the Senate GOP's balanced budget amendment.

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Tilting at windmills here.

The government might shut down for really no reason and the GOP extremists would be blamed to the detriment of the entire party.

Better to hold his fire for the debt ceiling vote.

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